| NPI | 1821505215 |
|---|---|
| Doing Business As | MEDCLUB BY DR. JENN |
| Entity Type | Organization |
| Authorized Contact | ZAQUERI WAYNE WILSON Practice Manager/Co Owner 561-214-3323 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X |
| Enumeration Date | 2018-01-07 |
| Last Update Date | 2018-01-07 |